Positive Elisa Indeterminate WB Negative Determine HIV Test

Mar 13, 2011

Dear Dr. Bob,

I recently applied for an insurance policy that required me to undergo an HIV test. The results came Positive ELISA and Indeterminate Western Blot. No further details have been shared with me. I immediately took a Determine HIV 1-2 Test and it came back negative. I did another Determine HIV 1-2 test a week later and it also came back negative.

I have never engaged in any sexual activity other than with my wife. We have been married for the last 6 years and also have a small kid one and half year old. My wife is HIV negative. I too had tested HIV negative two years back.

Incidentally last October I took Influenza vaccination along with Swine Flu Vaccine.

I want to understand from you is it possible that the ELISA test is reacting to cross-reacting antibodies from the Swine Flu Vaccination while the Determine HIV 1-2 test is not? In addition, could this be the likely cause of Indeterminate HIV 1-2 test?

The doctor has advised me to go for another WB. I am expecting the results the next week. I am quite tensed. Please advise.

Response from Dr. Frascino

A reactive (positive) screening ELISA plus an indeterminate WB is considered an overall indeterminate result. Cross-reacting antibodies (from vaccination or other causes) are a common cause of indeterminate HIV antibody test results. Your two subsequent negative HIV-1/2 antibody tests confirm your HIV-negative status. I would not suggest running another Western Blot (WB) unless you have another positive ELISA first. Isolated WB tests can result in false-positive/indeterminate results. WB tests should only be run to confirm a repeatedly reaction/positive screening HIV-antibody test (ELISA, EIA, rapid test, etc.).

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